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New York Hospitals Struggle With Flu Surge

New York City hospitals are struggling to manage a widespread flu epidemic that is stretching their emergency rooms and wards to overcapacity and forcing workers to ratchet up the overtime, doctors to cancel some elective surgeries and administrators to air out unused wards for patients who are flowing through the doors.

The Federal Centers for Disease Control and Prevention has reported only sporadic outbreaks of flu around most of the country, but it cites New York as one of a very few areas where the illness is extensive. ''New York is definitely different from the rest of the nation,'' said Barbara Reynolds, a spokeswoman for the centers.

Further, the strain of the virus most prevalent this season appears to be causing higher temperatures in patients and longer periods of coughing, vomiting and general misery than in years past. ''This high fever is not typical of other flus,'' said Dr. Sigurd Ackerman, the president of St. Luke's-Roosevelt Hospital Center. ''This one makes people feel sicker, quicker.''

Those who are particularly suffering, many doctors said, are young children, whose bad flus quickly lead to ear infections and respiratory difficulties. Pediatricians around the city said in interviews that their offices had been overwhelmed this month, and emergency rooms were reporting a higher-than-normal number of children seeking treatment.

''I haven't seen it this bad since 1989,'' said Kenneth E. Raske, president of the Greater New York Hospital Association.

As a result, most hospitals have been begging ambulance services to divert patients elsewhere and are resorting to desperate measures to house those who do come in.

''We have people double- and triple-parked in the E.R. on stretchers,'' said Dr. Elliot Friedman, the associate director of emergency medicine at Jamaica Hospital Medical Center in Queens, echoing accounts by other emergency room doctors in the city. ''And there have been times when upwards of 40 people have been admitted but are waiting for someone to be discharged, so we can quickly clean a room and refill it. And every time you turn around, someone else is pulling another ambulance in while someone else is heaving into a bucket.''

Although the flu does not automatically mean a trip to the emergency room, many of the city's uninsured seek all their health care through the E.R. Also, severe dehydration and other symptoms, especially among children and the elderly, sometimes create a need for emergency care.

Although no epidemic has been reported in the rest of the state, hospitals upstate have also had a tough January, aggravated by an ice storm that overwhelmed many emergency rooms with cases of broken bones at the same time that flu patients were arriving at the wards.

Hospital advocates are quick to point out that some of the overcrowding may be a result of centers' closing up beds in recent years to become economically efficient.

''The chickens have come home to roost,'' said Jeannie Cross, a spokeswoman for the Healthcare Association of New York State, a trade group representing hospitals in the northern part of the state. ''Downsizing, taking beds out of service and so forth to adapt to competition are fine when the weather is good and there isn't a flu epidemic and ice storm.''

At both hospitals run by Montefiore Medical Center in the Bronx, wards that were either long closed or under renovation were quickly reopened and staffed to deal with the influx of patients. A corner of one emergency room was turned into an intensive-care unit to serve five patients on respirators. Still others were sent to open beds on the oncology ward, and some patients awaiting elective surgeries were steered to the ambulatory units.

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''We are operating above 100 percent capacity,'' said Dr. Brian Currie, the medical director of the acute-care division of both Montefiore hospitals. ''We want patients to realize that the exasperating delays that seem like operational inconveniences are the same everywhere. We are trying really hard.''

At Lenox Hill Hospital on the Upper East Side, the tales of woe are similar. ''This is the most significant sustained volume I have seen in my 10 years of doing this,'' lamented Dr. Michael Marin, chief of emergency services there.

As a result, the hospital postponed renovation of a 14-bed unit and reopened it, filling its emergency rooms with more workers, in part to keep up with the heavy flow and in part to take the place of doctors and nurses who have come down with the illness themselves.

And at the city's public hospitals, officials said that flu cases had risen anywhere from 33 percent to 240 percent when compared with last year's, with Elmhurst Hospital Center suffering the most.

In theory, conditions should not be this bad. The most common bug medical workers are seeing is the Type A Sydney variety, which causes respiratory problems. That strain was contained in the flu shot, which gives immunity to 75 percent of those who take it, said Dr. Ilya Spigland, Montefiore's director of virology.

The ''stomach flu,'' which is not a flu at all, according to information from the Centers for Disease Control, has also hit many people this year, landing them in the emergency rooms, too.

Virology experts seem to agree that it is more or less impossible to predict the route a virus will take, or to say why it is prevalent in one area over another. ''I don't know what the reason is,'' Dr. Spigland said. ''Perhaps it is because New York is a dense urban population with people exposing each other, and it is also very possible that the increase in respiratory infections may not be due to the flu.''

But the misery it causes is never ambiguous. Yolanda Lopez found herself on Wednesday night in the emergency room waiting area of New York Methodist Hospital in the Park Slope section of Brooklyn. Ms. Lopez, a 42-year-old maintenance worker, said that after two days of fevers and vomiting, she had decided to come by. After waiting more than six hours she still had not seen a doctor. Her 15-year-old daughter, Kathy, had been admitted to Methodist on Sunday and released Wednesday after her own bout with the flu.

''I never get sick,'' Ms. Lopez said. ''I've been vomiting, running fever, I have a pain in my stomach. It's been terrible. My boss told me, 'Don't come back until you get better.' ''

Hospitals are not the only ones under strain. Pediatricians around the city have said they cannot wait for this season to end. ''We gave the shots, but they keep coming in,'' said Dr. Alessandra Zullo, of West 11th Street Pediatrics in Manhattan.

Dr. Robert Saken, a partner in the SoHo Pediatrics Group, said he had to hospitalize some children for dehydration. ''It has been horrible,'' he said. ''The kids are having really high fevers and coughing like crazy and then the parents get sick and it is stressful for everyone.''